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Maine rates for HCPCS 15277

Application of skin substitute graft to face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits, total wound surface area greater than or equal to 100 sq cm; first 100 sq cm wound surface area, or 1% of body area of infants and children

Facilitymedian $2,692 · 10th–90th $2,692–$2,6920%50%100%$2,692Professionalmedian $339 · 10th–90th $195–$6030%10%10th90th$339$200.0$500.0$1.0K$2.0K$5.0K$10.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,691.53 / $2,691.53 / $2,691.53
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$194.98 / $309.03 / $602.56
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$251.19 / $363.08 / $549.54
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$245.47 / $416.87 / $758.58
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$245.47 / $436.52 / $691.83
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$194.98 / $295.12 / $524.81
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$251.19 / $416.87 / $758.58